Death of quadriplegic patient... Nurse testifies

An Intensive Care Unit (ICU) nurse denied receiving instructions for not to resuscitate a quadriplegic patient from the doctors who are accused of premeditatedly killing the patient.

She told the Court Presided by Judge Maher Salama Al Mahdi that she had worked with Emergency Assistance section of the ICU and often helped resuscitate the quadriplegic patient.

“Whenever the patient flipped over from one side to the other, his heart used to stop. There was no direct order regarding lifting life support. Several doctors had a discussion regarding the subject,” she testified.

According to the records, doctors at Rashid hospital identified as EE, 50, Austrian, and MOK, 49, Indian are accused of premeditatedly killing a quadriplegic patient by not providing him the needed CPR when he had a heart attack on February 21, 2009.

Being head of the Intensive Care Unit, EE is accused of giving instruction not to provide CPR to the patient if he has a heart attack intending to kill him as an inevitable result to his instructions and deeds.

The Prosecution also accused the head of the ICU for insisting to achieve his target with all means despite the objection of the medical team. He managed to remove the devices connected to the patient needed to rescue him including those of the oxygen montoring and the alarm. He is also accused of increasing the rate of morphine given to the patient and reducing the rate of oxygen given to him.

MOK, the ICU doctor on duty, agreed with EE and refrained from giving CPR to the patient who had a heart attack, according to the records.

The two doctors denied the accusations when appeared before the Court.

The records said that the patient’s heart beat slowed down gradually until stopped so he died as reported in his medical file.

Yaser Ahmad Masri, 50, Syrian, doctor testified that EE had given verbal orders and instructions to the nursing team not to provide CPR or medical assistance to the patient Ghulam Mohammed if he has a heart attack intending to kill him.

“A day prior to the incident, the patient had a heart attack and the doctor on Duty MOK, refused to give him CPR based on the instruction of EE. I insisted that he should be rescued if he has a heart attack. So he was supplied with all needed equipment and medication... But EE came a day before the death of the patient and removed all the equipment and MOK, who was on duty, did not provide him with the needed CPR.”

Ashraf Mahmoud Al Hofi, 50, Intensive Care Consultant, Egyptian testified that he headed a medical committee to investigate the death of the patient.

The committee reached that EE has given oral directive and indirect instructions not to give the patient CPR or any medical supportive measure violating the medical regulations.

“There were notes in the deceased’s file that confirm this. The patient was not clinically dead but was conscious. The death was caused because no CPR was provided to him when he had a heart attack based on the instructions of EE; and MOK was responsible as he executed the instructions,” he testified.

Amin Najmi, 40, ICU nurse, Pakistani, testified that on the day of the incident he took over the shift from another nurse who told him that the doctors committee decided not to give the patient CPR in case he had a heart attack.

“The subject patient had a heart attack, I notified the duty doctor, MOK, who told me that it is not allowed to give the patient CPR and when I enquired from him about the reason he replied that it is our decision and left the nursing room,” Najmi testified.

Marline Shakoshan, 30, Indian nurse repeated similar testimonies and added that EE ordered to remove the oxygen monitory device at the time when his condition required monitoring rate of oxygen in his blood. This device is also connected to the alarm, which was inactivated as well.

“I have written in the patient’s file that CPR was not provided based on the order of EE. Furthermore, doctor MOK refused to give CPR to the patient following those orders,” she testified.

The prosecution provided the court with technical evidences including decisions taken by EE which were in contravention of administrative, procedural and clinical terms and also immoral regardless of the justification provided by the accused. 

MOK admitted that the instruction of not giving CPR to the patient was given by EE were known to all nursing team. EE was willing to kill the patient, he testified.

The records mentioned that EE entered the patient’s room at the end of the working day before the weekend and removed all devices connected to the patient. Doubling the rate of the morphine given to the patient was aimed to avoid showing the worsening condition of the patient.

EE was keen to remove the alarm connected to the patient so that there will be no alarm in case of emergency condition and no one would provide the needed support, according to the prosecution notes.

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